Screening for psychosocial morbidity in children with type 1 diabetes mellitus in an urban setting

Abstract

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease caused by absolute insulin deficiency. As per 2015 estimates, the number of affected children (<15 years) in India is estimated to be 70,200 children,[1] contributing almost 8% of the global burden. It poses additional challenges in the form of emotional stress and psychosocial adjustment problems. Materials and Methods: This was a cross-sectional study on 101 subjects. The Strengths and Difficulties Questionnaire (SDQ) was used to survey mental health symptoms and positive attitudes. The Quality of Life (QoL) Questionnaire was used to assess the QoL. Results: The prevalence of Total difficulties score (TDS) with clinically significant problems was seen in 17.6% of the children. A statistically significant positive correlation was found between HbA1c levels and parent-reported TDS scores (r = 0.692, P < 0.0001). As the HbA1c levels increase, the peer problems (r = 0.322, P = 0.008) and prosocial behavior problems (r = −0.254, P = 0.028) significantly increased. Conclusion: The most common abnormal SDQ scores were found in conduct problems (38.2%) and emotional problems (35.3%). Regular monitoring of lipid profile, blood pressure, and renal indices is important to observe the effects of T1DM on end organs, along with timely screening of children and adolescents for diabetes and psychosocial illness, educating the caregivers about diabetes, monitoring of diet, psychosocial illness, and means to cope with them, which can also improve the psychological well-being and in turn QoL of children and adolescents.